Crazy? Not Really! A Brainstorming on Ideas to Change Anesthesia Practice on the Next Ten Years

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Pro-inflammatory triggers in childhood obesity: correlation between leptin, adiponectin and high-sensitivity C-reactive protein in a group of obese Portuguese children

INTRODUCTION: Pediatric obesity is increasingly prevalent in the Portuguese population. Adipocyte dysfunction results in the expression of pro-inflammatory mediators that are responsible for the low-grade inflammatory process that characterizes obesity. OBJECTIVES: The aim of this study was to investigate the relationship between markers of adiposity, inflammation and adipokines in a Portuguese obese pediatric population. METHODS: One hundred and twenty children of both sexes, aged 6-17 years, were included in this study. The control group consisted of 41 healthy normal-weight children. The variables analyzed were age, gender, body mass index, waist circumference, fat mass percentage, high-sensitivity C-reactive protein (hs-CRP), leptin and adiponectin. RESULTS: There were significant differences between controls and obese children for all parameters analyzed. In the obese group, after controlling for age and gender, hs-CRP (p=0.041), adiponectin (p=0.019) and leptin (p<0.001) still showed significant statistical differences. A direct correlation was found between hs-CRP, leptin, body mass index and waist circumference, the strongest being with leptin (r=0.568; p<0.001). This trend remained statistically significant, regardless of gender or pubertal age. CONCLUSIONS: Considering the role of leptin, adiponectin and hs-CRP in the genesis of endothelial dysfunction, they may be used in clinical practice for risk stratification, as well as in the assessment of weight control programs

Risk Factors for Active Asthma at School Age: an 8-Year Prospective Study

A sibilância recorrente na infância é uma entidade clínica prevalente e heterogénea do pontode vista da história natural e do prognóstico. Efectuou-se um estudo prospectivo com 8 anos de duração, com o objectivo de relacionar a evolução clínica da sibilância recorrente nos primeiros anos de vida, com factores de prognóstico associados com a persistência da sintomatologia. Uma coorte de 308 crianças com sibilância recorrente, com idade ≤6 anos, foi incluída no estudo em 1993. Foi aplicado um questionário clínico, realizados testes cutâneos por prick e efectuado doseamento sérico de IgE total. Em 1996 procedeu-se a uma primeira reavaliação sistemática destas crianças. Em 2001 foi efectuada nova reavaliação sistemática, possível em 81% destas crianças (n=249), com repetição dos testes cutâneos e realização de avaliação funcional respiratória,em período intercrise, com espirometria com prova de broncodilatação (BD). As crianças reavaliadas apresentavam média etária de 11 anos (8-14 anos) e relação sexo M/F de 1.7/1. Permaneciam sintomáticas em 61% dos casos. A prevalência de atopia foi de 48% em 1993, 65% em 1996 e 75% em 2001. Pela realização de um modelo de regressão logística múltiplo foram identificados como factores de risco para asma activa em idade escolar: história pessoal de rinite alérgica (OR=15.8, IC95%=6.1-40.8; p<0.001), asma paterna (OR=7.2, IC95%=1.7-29.7; p=0.007), história pessoal de eczema atópico (OR=5.9, IC95%=2.2-15.7; p<0.001), asma materna (OR=5.4, IC95%=1.7-17.1; p=0.004), evidência de sensibilização alergénica (OR=3.4, IC95%=1.2-10.4;p=0.03) e início dos sintomas ≥2 anos de idade (OR=2.1, IC95%=1.1-4.8; p=0.04); a frequência de infantário antes dos 12 meses de idade foi identificada como factor protector (OR=0.4, IC95%=0.2- 0.9; p=0.04). Desenvolveram sensibilização alergénica de novo (ácaros do pó >80%) 66 das 128 crianças não atópicas em 1993 (52%). Apresentavam obstrução brônquica 36% das crianças: 47% das sintomáticas e 18% das assintomáticas (p<0.001). A prova de BD foi positiva em 35%: 47% nos sintomáticos e 13% nos assintomáticos (p<0.001). Concluindo, foram identificados como factores de mau prognóstico, antecedentes pessoais de doença alérgica, história parental de asma, presença de sensibilização alergénica e início dos sintomas na segunda infância. Os sintomas clínicos podem preceder em anos a sensibilização alergénica, realçando a importância da instituição precoce de medidas de controlo ambiental. Alterações nas provas funcionais respiratórias, mais frequentes nas asmas activas, estavam também presentes em crianças actualmente sem clínica, reforçando a necessidade de valorizar marcadores objectivos nesta cada vez mais prevalente doença respiratória crónica

The use of cheese whey for probiotic yogurt production

The objective of this work was to develop a natural yogurt utilizing the resultant whey of a "coalho" cheese production, assaying different processes of pasteurization and powdered milk concentrations. The yogurt submitted to 90 degrees C/5min with 8 and 10% of powdered milk achieved the highest grade on sensorial analysis, with no significant difference ( P > 0,05). Products were characterized as integral, attended the request for protein, and supplied over 15% of the daily feed intake of calcium for children aged 1 to 10, characterizing it as calcium enriched. In both formulations, the pH decreased from 4.6 to 4.2 approximately and the acidity increased from 0.7g to 1.0g lactic acid/100g of product during 28 days of storage. There was no contamination by S. aureus, fecal coliforms, molds and yeasts. The counting of lactic bacteria varied from 5.6x10(9) to 8.0x10(8) CFU/g during shelf life, suggesting the promotion benefits from this probiotic product. It was concluded that whey utilization for yogurt production is a viable alternative to increase economic, nutritional, and functional value.634996100

The transmission of Leishmania infantum chagasi by the bite of the Lutzomyia longipalpis to two different vertebrates

<p>Abstract</p> <p>Background</p> <p>Sandflies are vectors of <it>Leishmania</it>, the causative agent of leishmaniasis in mammalian hosts, including humans. The protozoan parasite is transmitted by the sandfly bite during salivation that occurs at the moment of blood feeding. The components of vector saliva include anticlotting and vasodilatory factors that facilitate blood flow and immunomodulatory factors that inhibit wound healing and quell the immune response. Not surprisingly, these factors also play important roles in the establishment of <it>Leishmania </it>infection. To date, the majority of knowledge that has been generated regarding the process of <it>Leishmania </it>infection, including <it>L. infantum chagasi </it>transmission has been gathered by using intradermal or subcutaneous inoculation of purified parasites.</p> <p>Findings</p> <p>This study presents the establishment of a transmission model of <it>Leishmania infantum chagasi </it>by the bite of <it>Lutzomyia longipalpis</it>, the vector of American visceral leishmaniasis. The parasites were successfully transmitted by infected sandfly bites to mice and hamsters, indicating that both animals are good experimental models. The <it>L. infantum chagasi </it>dose that was transmitted in each single bite ranged from 10 to 10, 000 parasites, but 75% of the sandflies transmitted less than 300 parasites.</p> <p>Conclusions</p> <p>The strategy for initiating infection by sandfly bite of experimental animals facilitates future investigations into the complex and dynamic mechanisms of visceral leishmaniasis. It is important to elucidate the transmission mechanism of vector bites. This model represents a useful tool to study <it>L. infantum chagasi </it>infection transmitted by the vector.</p

Pseudomyxoma peritonei: a clinical case of this poorly understood condition

BACKGROUND: Pseudomyxoma peritonei is an uncommon condition with an estimated incidence of one to two per million (worldwide) per year. It is characterized by the peritoneal deposition of mucinous tumors, most commonly of the appendix, and occasionally from the ovary, coupled by mucinous ascites. CASE PRESENTATION: We report the case of a 76-year-old woman who presented with increased abdominal girth and dyspnea for 2 weeks. She was diagnosed as a case of pseudomyxoma peritonei. She was submitted to right oophorectomy, omentectomy, and pseudomyxoma debulking. The histology was compatible with a mucinous tumor of colorectal/appendicular origin. Chemotherapy was not administered because of her functional status. Two years and 8 months later, she refers with postprandial fullness and has moderate ascites

Magnetocaloric effect in GdGeSi compounds measured by the acoustic detection technique: Influence of composition and sample treatment

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)In this paper we explore the acoustic detection method applied to the investigation of the magnetocaloric effect in Gd and Gd(5)(Ge(1-x)Si(x))(4) compounds, in the temperature range from 230 to 360 K and for magnetic fields up to 20 kOe. Measurements were performed in as-cast materials, both for powder and pellet samples, and in tree samples with compositions around Gd(5)Ge(2)Si(2) that underwent different thermal treatments. Small differences were observed when comparing powder and pellet samples of Gd and Gd(5)(Ge(1-x)Si(x))(4) compounds with 0.500<x <= 1.00. For the alloys with composition around Gd(5)Ge(2)Si(2), which exhibit giant magnetostriction and coexistence of distinct phases, expressive changes were observed when comparing powder and pellet samples. Based on these cases, it is easy to see that the acoustic method can distinguish a second-order phase transition from a first-order magnetic-crystallographic one, and that it presents good sensitivity to detect spurious material phase in small quantities. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3357375]1077Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)FAEPEX-UnicampFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES